Gliederung

Introduction

In Germany there is a deficit in drug use epidemiology, concerning methodology and relevance for health services research. Also, for international comparison, the development of epidemiological standards is necessary.

Methods

Both the basics of epidemiological drug research, e.g. uniform definitions for the respective populations, or the availability of epidemiological tools and their use in the drug field in Germany were analyzed.

Results

For classification of the IDU population, a variety of parameters such as drug use patterns or other dependency markers can be used single or be combined to classification systems such as ICD-10, DSM-IV or DRG. For epidemiological use of these data, there are „conventional“ tools for prevalence and incidence estimation such as surveys or multiplication methods, compared to more „modern“ methods such as capture-recapture or mathematical modelling recently coming into use in the drug field. In Germany, the published IDU prevalences mainly base on surveys and range between 0,2-0,5 %, with incertainty in many aspects.

Discussion

Already the available classification systems show advantages and disadvantages, regarding international dissemination, medical discipline specificity, usability, and validity. Furthermore, both “conventional” and “modern” epidemiologic methods differ markably with respect to their theoretical values and their practicability. Finally, the usefulness of the acquired informations for health planning has to be questioned.

Conclusions

Classification systems for epidemiologic studies in the drug field still have to be refined. An epidemiologic „gold standard“ yet cannot be derived from the available methods. From a methodological point of view, as a „stand alone“ method, capture-recapture seems to have the greatest potential, both for point estimates and for continuous monitoring. However, instead of a single method a panel of methods should be used to improve internal validity and usability for health planning. An even greater potential may derive from mathematical modelling.